RT Journal Article
SR Electronic
T1 Flow diverter assisted coil embolization of a very small ruptured ophthalmic artery aneurysm
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr2013010876
DO 10.1136/bcr-2013-010876
VO 2013
A1 David Dornbos III
A1 Promod Pillai
A1 Eric Sauvageau
YR 2013
UL http://casereports.bmj.com/content/2013/bcr-2013-010876.abstract
AB Small ruptured aneurysms present a unique problem to endovascular therapy. We report a case in which a patient presented with subarachnoid hemorrhage and a very small ruptured ophthalmic artery aneurysm, for which endovascular therapy was preferred secondary to severe cardiac comorbidities. Due to the aneurysm size, a small 1.5 mm coil was needed, but presented a significant risk of migration. Conventional stent assisted coiling was considered suboptimal as the small coil could have easily migrated through the strut. We present a novel technique of flow diverter assisted coil embolization in which a coil was placed within the aneurysm and a pipeline embolization device was then partially deployed, jailing the microcatheter and coil mass. Once in place, the coil was detached, securing the aneurysm, and preventing coil migration. Through the use of a flow diverter, some degree of aneurysm protection would still be expected in the event of coil migration toward the ophthalmic artery origin.